End-stage reflux nephropathy.

Gross vesico-ureteric reflux is the essential pathogenetic factor in the etiology of the small, scarred kidney of non-obstructive, chronic pyelonephritis (reflux nephropathy). 18 (12.5%) of 144 patients entering a dialysis-transplant programme had end-stage reflux nephropathy. The majority of patients initially presented with severely impaired renal function, hypertension and significant proteinuria. Documented urinary tract infections had only occurred in one-third of the patients. 8 of the 12 women presented during a pregnancy, usually with a presentation resembling toxaemia of pregnancy. Reflux nephropathy is a significant cause of end-stage chronic renal failure.